Fentanyl is a big culprit, but there are also encouraging signs from states that have prioritized public health campaigns and addiction treatment.By Margot Sanger-KatzAug. 15, 2018 New York Times

Drug overdoses killed about 72,000 Americans last year, a record number that reflects a rise of around 10 percent, according to new preliminary estimates from the Centers for Disease Control. The death toll is higher than the peak yearly death totals from H.I.V., car crashes or gun deaths.Analysts pointed to two major reasons for the increase: A growing number of Americans are using opioids, and drugs are becoming more deadly. It is the second factor that most likely explains the bulk of the increased number of overdoses last year.The picture is not equally bleak everywhere. In parts of New England, where a more dangerous drug supply arrived early, the number of overdoses has begun to fall. That was the case in Massachusetts, Vermont and Rhode Island; each state has had major public health campaigns and has increased addiction treatment. Preliminary 2018 numbers from Massachusetts suggest that the death rate there may be continuing to fall.But nationwide, the crisis worsened in the first year of the Trump presidency, a continuation of a long-term trend. During 2017, the president declared the opioid crisis a national public health emergency, and states began tapping a $1 billion grant program to help fight the problem.TO CONTINUE READING: https://www.nytimes.com/2018/08/15/upshot/opioids-overdose-deaths-rising-fentanyl.html

Fentanyl is a big culprit, but there are also encouraging signs from states that have prioritized public health campaigns and addiction treatment.By Margot Sanger-KatzAug. 15, 2018 The New York Times

Drug overdoses killed about 72,000 Americans last year, a record number that reflects a rise of around 10 percent, according to new preliminary estimates from the Centers for Disease Control. The death toll is higher than the peak yearly death totals from H.I.V., car crashes or gun deaths.Analysts pointed to two major reasons for the increase: A growing number of Americans are using opioids, and drugs are becoming more deadly. It is the second factor that most likely explains the bulk of the increased number of overdoses last year.The picture is not equally bleak everywhere. In parts of New England, where a more dangerous drug supply arrived early, the number of overdoses has begun to fall. That was the case in Massachusetts, Vermont and Rhode Island; each state has had major public health campaigns and has increased addiction treatment. Preliminary 2018 numbers from Massachusetts suggest that the death rate there may be continuing to fall.But nationwide, the crisis worsened in the first year of the Trump presidency, a continuation of a long-term trend. During 2017, the president declared the opioid crisis a national public health emergency, and states began tapping a $1 billion grant program to help fight the problem.TO CONTINUE READING:​https://www.nytimes.com/2018/08/15/upshot/opioids-overdose-deaths-rising-fentanyl.html

The Food and Drug Administration on Monday announced a shift in the way it evaluates drugs to treat opioid addiction that the agency says will give it more flexibility to approve new treatments.Now, rather than merely examining whether a potential treatment reduces opioid use, the agency will consider factors like whether a drug could reduce overdose rates or the transmission of infectious diseases.“We must consider new ways to gauge success beyond simply whether a patient in recovery has stopped using opioids, such as reducing relapse overdoses and infectious disease transmission,” FDA Commissioner Scott Gottlieb said in a statement.

The announcement is the latest in a string of efforts to improve the federal government’s response to the growing opioid crisis, which also includes legislation on Capitol Hill that aims to ensure treatment is evidence-based and, separately, to ensure more federal programs will pay for methadone treatment.The many outcomes Gottlieb cited included mortality (both overall and from drug overdoses) and disease transmission, given the many communities that have seen outbreaks of HIV/AIDS and hepatitis concurrent with increased rates of injection drug use.MAT, coupled with psychosocial counseling, is widely acknowledged to be the standard of care in treating opioid addiction.Currently, just three drugs exist to treat opioid use disorder: buprenorphine, methadone, and naltrexone. Adherence to the drugs is typically low, and addiction treatment experts have long said MAT is vastly underutilized, calling for expanded access to existing options and the development of more drugs beyond the existing three.In its guidance, the FDA said encouraging drug developers to consider outcomes beyond drug use could yield significant health benefits.